We noticed that Ryan is still confusing "pat head" and the "more" sign when he wants more wagon ride. I told T. about this, and she watched us (Grandma was with us today) pulling Ryan in the wagon, and pausing for his reaction. She noticed, as we also had noticed, that Ryan seems to be reading our body language and scrolling through his repertoire of actions until he gets the right one that will get the wagon moving again. T. suggested the key here is to reinforce immediately after he does the "more" sign, and before he can squeeze in a "pat head." It's tricky; Ryan is fast! The problem is, he might start pairing doing both "pat head" and "more" to get the wagon going. So, the instant he signs more, one person has to pull the wagon, and a second person has to sign "more" back at him, and say, "Yes, you want more!" We tried this a few times and it worked; it was like Ryan needed that second person's reassurance that he had done the "more" sign correctly, so he didn't have to pat his head.
Mom had a few lapses today, too. I needed a reminder (and Gram had to be taught) that we shouldn't verbally address what we don't want to see (i.e., "not in your mouth!"), but focus on what we DO want to see (i.e., "put the ball on!"). I was also trying to get Gram involved in some of the programs, and T. asked me, "Has she seen that one before?" I realized that it made more sense for Gram to see me do it with Ryan first, and then guide her in a few trials. I knew it felt awkward, but I have had a fuzzy brain this week. Of course the program would go awkwardly if I'm trying to get Gram to do it without ever seeing it, and at the same time explaining it to her, and also trying to help Ryan from a different position than I usually do the program! Duh.
One interesting thing I noticed today is how well Ryan followed Grandma's commands. We still have "go play" as an incidental goal at S.C., but it's always a - when I try it with him. Today, we noticed Ryan liked the big bead maze, so we brought it to the Blue Room with us. When I said Ryan could have a little break, Gram turned his chair toward the bead maze (about 3 feet away), and told him to "Go play!" To my amazement, he did! He went right over to the bead maze. In fact, he responded to "Go play" twice for Grandma! He also stood up and followed her a couple of times when she stood up and held out her hand, and waited for him to follow. Hmm. He never follows my instructions that well. It must be a special Grandma power!
"Pat head" and "clap" is where Ryan's case of the Mondays on a Tuesday really seemed to come up. He was not at all focused on me, and was more attentive to other voices/activities in the Blue Room. He got 0/5 and 1/5 on the trials, because I was expecting him to do the actions with zero physical prompts, or at least a reduced prompt. The one + he got was on a "pat head" where Grandma barely tapped his right elbow, and then he did it.
I decided to show Gram the "colouring" program after that because I know Ryan can be more successful with that. (It can get very frustrating for anyone who doesn't have some chances for success, so I like to pull out a program Ryan likes/is good at after he's struggled over something else.) For the first few tries, Ryan was pushing the marker and getting some good marks on the paper, but the criteria for a + on this one is that he has to have some kind of grasp on the marker as he pushes it. It's funny; I think he overheard T. reminding me of this because each trial after that, he had a really good grasp on the marker!
Since we were at the table, I set up Play Doh next, and showed Gram how we do it. Ryan was putting his hand over his ball of Play Doh when shown the model and given the instruction to "squish it," but he wasn't putting the pressure on it today. We tried a bunch of different things to get him to push down (different hand positions, reduced HOH-wrist prompt, using a stamper, etc.), but we didn't come up with any answers. It's odd; he did a little bit independently yesterday, but had no motivation today. Hopefully it was just that Mondays-on-a-Tuesday striking again.
We also attempted the three-piece animal puzzle today. It's been a while for that one, but I still started out at a wrist prompt. His grasp was pretty limp and he was unenthusiastic about the activity. He didn't even enjoy pulling the pieces out, like he usually does. I had to encourage him quite a bit to hold onto the pieces and try to place them. We did it twice, and he got 3/6 pieces in at a wrist prompt. However, he got the last piece in independently, so I think he was becoming more attentive by the end of the activity.
Circle time was a struggle again today. Ryan was crying a lot, and he was not too interested in participating. He did some matching and pulling off pictures, but his attentiveness and participation during songs was lacklustre. I was like a puppeteer and Ryan was my little puppet today; I tried to move him to do the actions, but his mind wasn't really there.
Snack time offered a bit of a respite. He did take a couple of nice, independent bites of yogurt, which I haven't seen him do since we got sick. I think he was showing off for Grandma. :) That's fine, I'll take it.
After snack, we did the shape sorter, and Ryan did surprisingly well. This is another one we hadn't done in a while, but he was putting the circles in perfectly, and the triangles and squares he was getting in with a wrist prompt. It was great to see how persistent he was at wiggling the pieces around until they fell into the hole. I gave him his desired reinforcement of letting him open the container and pull all the pieces out after. :)
Then, we tried some more with the magnetic balls toy from yesterday. Ryan was good at putting the balls in place with just a wrist prompt, but taking them off was a challenge again. We tried different techniques and motivators to get him to pull the balls off (positioning, modeling, reinforcement, etc.) at a wrist prompt or less, but he wouldn't do it. It's frustrating because we saw him do this before. We know he can do it. But since it became part of the program, he's lost all motivation to pull those balls off. Grr.
Next, I set up the "push a train" trial. Ryan did well with this. He needed to be redirected to the train table a few times, but he would push the train appropriately. He got 4/5 trials correct. The last trial was a - because he was starting to get defiant. It wasn't that he couldn't do it; he was just tired of it and wanted to walk away.
After that, we moved into the Rainbow Room to do "kick ball." (Actually, we teased out the wagon confusion first, as I discussed at the start of the post. Then we played kick ball.) It seems that the "cuddles" reinforcement is Ryan's preference at the end of the morning, when he's tired. We used that again, and Ryan was successful. We had him kicking the ball to the other person (either me or Grandma) two or three kicks, and then he got his cuddle.
The other family had to eave at about 11:10, and I felt we were ready to go at that point, too. Ryan was getting tired (droopy eyes when we cuddled!), and Mommy's sore throat/ears/head were getting worse again. Ryan waved bye-bye to a few people, and home we went.
[Note: I am writing this post on Wednesday. We're at home because I'm knocked out again by this virus/infection/whatever it is again, and Ryan was awake all night, too. I was so sick last night I didn't do my blog. I didn't even do my little Facebook blurb; that's why there isn't one for this entry.]
ABLLS
This is an aside, but might be of interest to you. I mentioned in Monday's post about doing the ABLLS assessment for Ryan. When all 500+ skills have been rated, they are recorded on a grid, to give you a visual of what has changed since the last assessment was conducted.
The first assessment in January, done by L., is coloured in green. The second assessment, done by me this week, is recorded in orange. Any blank spots means that Ryan is not doing that skill yet. Keep in mind, this assessment is up to kindergarten, and Ryan's only 3, so I wouldn't expect him to do all of them yet. Still, if you see the very few green spots and the growing number of orange spots, it's an overall visual of the amount of improvement Ryan had made. All orange squares would represent a new skill or an improvement in a skill that he has acquired over the past 10 weeks.
(If you click on the picture, a bigger version pops up, so you can read the general categories being assessed at the bottom.)
Pretty Flower Arrangement Ryan and I did together way back on Easter Fun Day at S.C.
(just got it home this week)
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